How traveling to Houston healed Keri Carlson’s SMA Syndrome

Keri Carlson, a Tennessee resident, had dealt with stomach issues for as long as she could remember. Born with a congenital defect, she had experienced digestive discomfort throughout her life. While she was able to manage them by watching what she ate and avoiding overeating, she started facing severe issues last year.

She started experiencing intense nausea and vomiting. The pain, especially after eating, became unbearable, forcing her to lie down to find relief. There were times when she could no longer function normally, and the discomfort began to severely impact her quality of life.

“The stomach pain and vomiting issues were very difficult to deal with,” she said. “I was unable to eat out in restaurants or enjoy family meals. The pain would wake me up at night, so my sleep was disrupted and I constantly felt fatigued.”

Carlson went to her general practitioner, who then referred her to a gastroenterologist, who initially suspected an ulcer. Despite losing weight with no clear explanation, the upper GI test showed no indication of an ulcer. She then went to a vascular specialist who revealed an unexpected finding – a vascular issue known as Nutcracker Syndrome, but this didn’t seem related to her symptoms.

As doctors puzzled over her condition, a follow-up upper GI test raised the possibility of superior mesenteric artery (SMA) syndrome, and Carlson’s vascular specialist agreed that SMA syndrome could be a potential diagnosis.

What is SMA syndrome?

SMA syndrome is an uncommon disorder that occurs when the superior mesenteric artery compresses the duodenum, the first part of the small intestine. This compression disrupts normal digestion, often leading to pain, nausea, vomiting and unintentional weight loss. The condition can be difficult to diagnose because its symptoms overlap with many other gastrointestinal disorders, and imaging tests can sometimes appear normal.

“What happens is the duodenum is pinched and partially obstructed, so the food backs up in the duodenum and sometimes into the stomach, which causes vomiting and/or severe abdominal pain,” said Dr. Robert Southard, Baylor Medicine surgeon. “Think of it like a garden hose that’s kinked: the water just doesn’t flow and things just back up.”

The GI doctor and vascular specialist were not sure who to refer Carlson to at that point because there were no SMA specialists in Tennessee. After a Google search, two doctors were recommended to Carlson and she chose Southard, who she found had published recent studies on SMA.

Finally, a diagnosis and treatment plan

When Carlson met Southard during last fall, she felt truly heard for the first time. Unlike other doctors who were uncertain and unable to offer clear answers, Southard took the time to understand her condition and ordered further studies. He identified compression in her upper digestive tract, confirming the SMA diagnosis.

“I think many people have this condition but don’t know what it is. I’m so grateful to Dr. Southard for his expertise,” Carlson said.

A life-changing surgery

In November 2024, Carlson underwent SMA surgery – a major procedure with a challenging recovery. The surgery, though difficult, proved to be worth the effort. The relief from her chronic nausea was immediate, and for the first time in years, Carlson felt free from the pain and limitations that had ruled her life.

“For patients like Keri Carlson who suffer from severe symptoms and have failed conservative treatments, surgery can be a life-changing solution,” Southard said. “By relieving the compression on the duodenum, we can significantly improve digestion, reduce pain and restore the patient’s quality of life.”

During the procedure, Southard connected Carlson’s duodenum to a lower segment of her small intestine, bypassing the compressed area to restore the normal flow of food and digestive juices.

“This approach not only alleviates the obstruction caused by SMA syndrome but also prevents recurring symptoms such as severe nausea, vomiting, abdominal pain and malnutrition,” Southard said. “The procedure directly addresses the root cause of these issues, offering a highly effective solution to improve the patient’s overall quality of life.”

Carlson’s journey is a reminder that when it comes to rare and complex conditions like SMA, having a dedicated and knowledgeable medical team can make all the difference. For those suffering from similar symptoms, finding the right specialist could be the key to unlocking a life free from chronic pain.

“Dr. Southard and his team were very responsive and caring throughout the entire process. Dr. Southard took the time to call me himself on several occasions when I had medical concerns. His calls were often made after hours, indicating to me a dedication to the care of his patients.”

If you or someone you know may have SMA syndrome, call 713-798-7911 for an appointment.

By Tiffany Harston, senior communications specialist in the Michael E. DeBakey Department of Surgery